Healthcare

This Act is a substitute for Senate Bill No. 101. It makes no substantive changes to Senate Bill No. 101 other than substituting the synopsis language from the prior bill for the new synopsis, as follows: This Act resolves a conflict between the Uniform Controlled Substances Act which requires an in-person examination to prescribe controlled substances for treatment of Opioid Use Disorder (OUD) and Delaware's telehealth regulations, the Telehealth Access Act which does not require an in-person examination. This bill connects and clarifies the two regulations by modifying the "patient-practitioner relationship" definition in Chapter 47, Title 16, the Uniform Controlled Substances Act, to include a practitioner treating OUD via telemedicine with Schedule III through V medication. The guardrails included in this short addition include: limiting the medication to only Schedule III through V, which has been approved by the FDA for the treatment of OUD and citing to the thorough requirements for establishing a provider-patient relationship under Section 6003 of Title 24, the 2021 Telehealth Access Act, which addresses requirements such as standard of care, medical record keeping, consent, and medical board oversight.

This Act allows drug manufacturers or their agents and wholesalers to ship dialysate drugs and devices directly to home dialysis patients without a pharmacy license.

The Department of Education (“Department”) currently administers the High Needs Educator Student Loan Repayment Program, the Speech-Language Pathologist Student Loan Repayment Program, and the Mental Health Services Student Loan Repayment Program. Annually, these programs help roughly 600 public school employees, including educators, speech-language pathologists, school counselors, school psychologists, and school social workers, through a single application process, by making loan payments directly to student loan lenders. But paying the lenders directly has caused 2 persistent issues: 1. Because the payments are considered taxable income, award recipients have the tax withheld from their paychecks, even though the payments go directly to the lenders. This lowers the award recipients’ take-home pay and can create confusion and hardship. 2. The process involves sending out 600 or more individual checks each year. And many checks are returned or delayed due to changes in lender information or system mismatches. To avoid these issues, the Department recommends combining the 3 different student loan repayment programs into a single program and changing the award process from a system that repays lenders directly to a system that pays stipends to public school employees through the State central payroll operation. These changes would streamline a system that already uses a single application and would do all of the following: 1. Avoid surprise tax impacts and imputed income issues. 2. Reduce administrative burden and failed payments. 3. Provide more timely and transparent support to award recipients. The suggested changes are easy to implement, budget-neutral, and could allow public school employees who previously declined awards due to the tax consequences to benefit from the financial support. This Act makes the changes recommended by the Department by doing all of the following: 1. Eliminates the separate Speech-Language Pathologist Student Loan Repayment Program, Mental Health Services Student Loan Repayment Program, and High Needs Educator Student Loan Repayment Program, and combines them into a single program under § 4163 of Title 14. 2. Shifts payment of awards from paying the lenders directly to paying the award recipients a stipend through the State central payroll operation. 3. Streamlines the process for determining financial need by allowing the Department to focus on collecting the income and loan information that is necessary to fairly allocate program funds. 4. Changes the title of § 4163 of Title 14 from the High Needs Educator Student Loan Repayment Program to the “Public School Employee Support Program for High Need Areas” because the 3 programs are now combined into a single program and the program is no longer a direct student loan repayment program. This Act also makes technical corrections to conform existing law to the standards of the Delaware Legislative Drafting Manual.

This Act provides a one-time increase of 3% in aggregate worker’s compensation medical expenses to correct reimbursements for medical services coded as evaluation and management (E&M) for worker compensation cases. This is needed as the E&M reimbursement rate for Workers’ Compensation cases has fallen below the reimbursement rate of the Center for Medicare & Medicaid Services rates. This is a critical need as the State of Delaware is in critical need of physicians to accept and treat worker compensation patients.

This Senate Joint Resolution directs the Division of Medicaid & Medical Assistance (DMMA) to explore amending our Delaware Medicaid State Plan to allow for the adoption of the Children’s Health Insurance Program (CHIP) From-Conception-to-End-of-Pregnancy (FCEP) option and the creation of a Health Services Initiative (HSI) that will allow our State to use federal funding to partially cover prenatal and postpartum care for individuals otherwise ineligible for free or low-cost health-care coverage due to immigration status. This Joint Resolution also requires DMMA to provide a report to the General Assembly as to its findings no later than January 1, 2026.

This resolution requires the Division of Medicaid and Medical Assistance to present a report to the Delaware General Assembly, by January 1, 2026, for the provision of insurance coverage for Community Health Worker services by Medicaid providers, which must include a draft State plan amendment or waiver, as appropriate, to the Governor and all members of the General Assembly, with copies to the Director and the Librarian of the Division of Research of Legislative Council, and the Delaware Public Archives.